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Abramson Cancer CenterNCI CANCERLIT® Search: Laryngeal Cancer - January 2002
National Cancer Institute®
Last Modified: January 1, 2002
Table of Contents
1
UI - 11370491
AU - Garden AS
TI -
Organ preservation for carcinoma of the larynx and hypopharynx.
SO - Hematol Oncol Clin North Am 2001 Apr;15(2):243-60, v
AD - Department of Radiation Oncology, University of Texas M. D. Anderson
Cancer Center, Houston, Texas, USA. agarden@mdanderson.org
Treatment of laryngeal and hypopharyngeal cancers often necessitates
total laryngectomy. This article reviews approaches of curing patients
with these diseases while preserving their larynx. Strategies include
radiation alone, neoadjuvant chemotherapy with radiation for responders,
or concurrent chemotherapy and radiation. Both retrospective experiences
and randomized trials evaluating differing therapies in an effort to
achieve voice preservation are reported and analyzed.
2
UI - 11370492
AU - Teknos TN; Hogikyan ND; Wolf GT
TI -
Conservation laryngeal surgery for malignant tumors of the larynx and
pyriform sinus.
SO - Hematol Oncol Clin North Am 2001 Apr;15(2):261-76
AD - Department of Otolaryngology-Head and Neck Surgery, University of
Michigan Health Center, Ann Arbor, Michigan, USA. teknos@umich.edu
Conservation surgery for cancers of the larynx and pyriform sinus is an
expansive and complicated subject. A great deal of technical expertise
and clinical judgement are required for appropriate surgical and
oncologic outcomes. In the appropriate setting, surgery continues to
play an important role in voice preservation for patients with laryngeal
and hypopharyngeal carcinoma. Perhaps most importantly, options for
organ preservation surgery have expanded, and the number of patients
requiring total laryngectomy as primary surgical management has
decreased. The medical surgical decision making is complex and requires
precise delineation of tumor extent, careful patient evaluation, and
thorough interdisciplinary discussion to select an optimal course of
treatment for the individual patient.
3
UI - 11407451
AU - Yilmaz T; Turan E; Gursel B; Onerci M; Kaya S
TI -
Positive surgical margins in cancer of the larynx.
SO - Eur Arch Otorhinolaryngol 2001 May;258(4):188-91
AD - Hacettepe University Faculty of Medicine, Department of
Otolaryngology-Head and Neck Surgery, Hacettepe Ankara, Turkey.
taneryilmaz@yahoo.com
In order to determine what should be done for laryngeal cancer patients
when surgical margins are positive, and to evaluate their prognosis, a
retrospective review of 21 laryngeal cancer patients with positive
surgical margins out of 714 surgically treated cases (2.9%) was carried
out. Nineteen patients were treated with postoperative radiation
therapy. Two patients who had had endolaryngeal partial laryngectomy
were treated with vertical partial laryngectomy. Two patients were lost
to follow-up. Ten patients (10/19; 53%) were recurrence-free. Four
patients had local, two had regional, and two had locoregional
recurrences. Only one patient with a local recurrence could be salvaged
with total laryngectomy and is disease-free. One patient developed liver
metastasis. Nineteen patients had a mean and median disease-free
survival of 48 and 36 months, respectively. Nine out of fourteen
patients (64%) treated curatively were recurrence-free. The patients
with positive margins developed significantly more locoregional
recurrences than those with free margins (P < 0.05). We conclude that
surgical margins must be checked peroperatively with frozen sections to
make sure that they are free. The margins of every laryngectomy specimen
must be diligently examined. If positive, re-excision, postoperative
radiotherapy and chemotherapy are treatment alternatives. They should
not just be managed with close follow-up. However, whatever treatment is
applied, the prognosis for patients with positive margins is
significantly worse than for those with free margins.
4
UI - 11444188
AU - Dreyer T; Knoblauch I; Doudkine A; MacAulay CE; Garner D; Palcic B;
TI -
Popella C
Nuclear texture features for classifying benign vs. dysplastic or
malignant squamous epithelium of the larynx.
SO - Anal Quant Cytol Histol 2001 Jun;23(3):193-200
AD - Institute of Pathology and Department of Otorhinolaryngology, Justus
Liebig University of Giessen, Langhansstrasse 10, D-35392 Giessen,
Germany. thomas.dreyer@patho.med.uni-giessen.de
OBJECTIVE: To search for nuclear features and feature combinations able
to assess malignancy and premalignant changes on tissue sections of
laryngeal squamous epithelium. STUDY DESIGN: A total of 139 lesions of
benign changes (BC) (n = 44), epithelial dysplasias (ED) (n = 50) and
invasive laryngeal cancer (LC) (n = 45) were retrieved from archival
pathology specimens. The goal of this study was to identify the best
features or feature combinations that discriminate BC from LC and also
reflect the degree of ED. In order to verify the results on independent
data, the groups were split into two separate subgroups, one for
training and one for testing. RESULTS: On the test set of slides, the
overall correct classification of BC vs. LC cases was 82% using only one
feature, fractal2_area. This classification rate could be increased to
91% when a discriminant function based on 10 features was used. However,
this gain was not significant. CONCLUSION: Fractal texture features can
be used to assess malignancy on tissue sections as an alternative to DNA
measurement. In this study feature combinations did not significantly
improve classification rates.
5
UI - 11482578
AU - Sarioglu S; Ozer E; Kirimca F; Sis B; Pabuccuoglu U
TI -
Matrix metalloproteinase-2 expression in laryngeal preneoplastic and
neoplastic lesions.
SO - Pathol Res Pract 2001;197(7):483-6
AD - Dokuz Eylul University, School of Medicine, Department of Pathology,
Izmir, Turkey.
Matrix metalloproteinase-2 (MMP-2), a member of gelatinases, is
particularly important in the digestion of nonfibrillary and denaturated
collagens; thus, it may play a role in tissue remodeling and in the
invasion of malignant cells. The expression of MMP-2 has not yet been
described in preneoplastic lesions of the larynx thus far. The purpose
of this study was to evaluate whether the expression of MMP-2 plays a
role in early laryngeal carcinogenesis. Laryngectomy specimens of 20
invasive carcinoma cases were studied. The slides with atypical
hyperplasia, carcinoma in situ, and invasive carcinoma were selected
from laryngectomy specimens. On these slides, 23 atypical hyperplasia
and 17 carcinoma in situ areas were identified. MMP-2 expression was
scored immunohistochemically on paraffin tissue sections using the
avidin-biotin-peroxidase method. MMP-2 expression in all three groups
was statistically different. A sequential increase in MMP-2 expression
correlated significantly with the hypothesis of multistep
carcinogenesis. In contrast, MMP-2 expression was not related to tumor
stage, lymph node metastasis, or differentiation in squamous cell
carcinomas. In conclusion, this sequential increase in MMP-2 expression
points to an altered expression of MMP-2 in early neoplastic
transformation in laryngeal mucosa, followed by an increasing expression
during the progression of the disease.
6
UI - 11489367
AU - Tomik J; Skladzien J; Modrzejewski M
TI -
Evaluation of cervical lymph node metastasis of 1400 patients with
cancer of the larynx.
SO - Auris Nasus Larynx 2001 Aug;28(3):233-40
AD - Otolaryngological Clinic Collegium Medicum, Jagiellonian University,
Cracow, Poland. korl@kki.net.pl
OBJECTIVE: The main goal of the paper was to evaluate the results of
surgical treatment of patients with laryngeal carcinoma, among whom
cervical lymph node metastases were observed. The results of treatment
were assessed after prior analysis of the following factors localization
of laryngeal carcinoma, local and regional advancement, number of lymph
nodes affected by metastases, the incidence of 'occult metastases', the
presence of metastases in the pre-laryngeal node, the regions of the
neck which were most frequently affected by metastases and supplementary
irradiation treatment. METHODS: An analysis of a group of 1400 patients
who underwent surgery for laryngeal carcinoma in the period 1948-1992,
was carried out. In all of the cases, a partial or total laryngectomy
accompanied by a unilateral or bilateral surgery of the cervical lymph
node system was performed. The results of the above treatment were
assessed over a 5-year survival period. RESULTS: In patients among whom
metastases to the lymph nodes were observed, it is the following factors
that exert an influence on survival chances: supraglottic and glottic
localization of the tumor, an increase of regional and organ advancement
of the tumor, number of lymph nodes affected by metastases, the presence
of metastases in the 'pre-laryngeal' node and the level of the neck
affected by metastases. CONCLUSION: The incidence of metastases in
regional lymph nodes is a prognostic factor in the treatment of patients
suffering from laryngeal carcinoma.
7
UI - 11167140
AU - Oreggia F; De Stefani E; Boffetta P; Brennan P; Deneo-Pellegrini H;
TI -
Ronco AL
Meat, fat and risk of laryngeal cancer: a case-control study in Uruguay.
SO - Oral Oncol 2001 Feb;37(2):141-5
AD - Academia Nacional de Medicina, Montevideo, Uruguay.
The effect of meat and fat in laryngeal carcinogenesis was examined in a
case-control study carried out in Uruguay in the time period 1998-1999.
One-hundred and forty patients with squamous cell laryngeal carcinoma
and 420 hospitalized patients, afflicted with conditions not related
with tobacco smoking, alcohol drinking or recent dietary changes
comprised the cases and controls in this study. All patients were
interviewed face-to-face in the hospitals with a detailed questionnaire
which included queries on 64 food items. Red and total meat intakes were
associated with strong increases in risk of laryngeal cancer (odds ratio
[OR] for high total meat intake 3.32, 95% confidence interval [C.I.]
1.23-8.95). This effect disappeared after controlling for total fat
intake. On the other hand, total fat intake displayed a strong
association with risk of laryngeal cancer when red meat was included in
the same model (OR for high fat intake 7.05, 95% C.I. 2.51-19.8). Total
fat intake combines its effect multiplicatively with tobacco smoking.
8
UI - 10646717
AU - Nikolaou AC; Markou CD; Petridis DG; Daniilidis IC
TI -
Second primary neoplasms in patients with laryngeal carcinoma.
SO - Laryngoscope 2000 Jan;110(1):58-64
AD - University Department of Otorhinolaryngology and Head and Neck Surgery,
AHEPA University Hospital, Aristotle University, Thessaloniki, Greece.
nikolaou@med.auth.gr
OBJECTIVES: To better define the characteristics of second primary
malignancies appearing in patients suffering from head and neck cancers,
and more specifically laryngeal carcinoma, and to elicit those
parameters that may be of assistance in better diagnosing, treating, and
predicting outcome in such patients. STUDY DESIGN: Retrospective review
of a group of 514 compliant subjects, examined and treated during an
8-year period until 1996. After initial diagnosis and subsequent
treatment, rigorous follow-up ensured systematic screening of the
subjects, who underwent standard examinations in outpatient clinics for
periods of up to 56 months. RESULTS: Of 514 cases followed, presence of
second primary neoplasms was established in 42 or 8.17%, 8 being
synchronous and 34 metachronous of the original primary lesion.
CONCLUSIONS: Respiratory and upper gastrointestinal localizations were
primarily affected, incidence was highest in septuagenarians, and
staging of the primary was found to be irrelevant to the incidence rates
of second primaries. No statistical significance was attached to the
fact that supraglottic primary tumors showed slightly higher second
primary rates; the same applying for well-differentiated primary tumors
compared with poorly differentiated ones. Modality of treatment surgery,
and radiotherapy being the options in question-did not in the long run
statistically influence incidence rates. Throughout, reference to
current literature and this study's relevance in light of similar
efforts were taken into account.
9
UI - 10983969
AU - Fergie N; Murty GE
TI -
Second primary neoplasms in patients with laryngeal carcinoma.
SO - Laryngoscope 2000 Sep;110(9):1586-7
10
UI - 11530473
AU - Antoniv VF; Rishko NM; Popadiuk VI; Pronchenko SV
TI -
[Clinical classification of benign ENT tumor]
SO - Vestn Otorinolaringol 2001;(4):24-7
The proposed clinical classification of benign ENT tumors is based on
division of anatomic regions (the ear, nose, pharynx, larynx) into
sections and fragments and allows to assess the spread of any ENT tumor.
Moreover, it agrees with TNM classification. The symbols "T" and R are
used which denote four variants (T1-4) or R1-4 for the tumor and
recurrence, respectively.
11
UI - 11520092
AU - Georgiou A; Gomatos IP; Ferekidis E; Syrigos K; Bistola V; Giotakis J;
TI -
Adamopoulos G; Androulakis G
Prognostic significance of p53, bax and bcl-2 gene expression in
patients with laryngeal carcinoma.
SO - Eur J Surg Oncol 2001 Sep;27(6):574-80
AD - Department of Otolaryngology, Hippokration Hospital, Athens, Greece.
AIM: This study was designed to examine the prognostic significance of
the coexpression of three genes (bax, bcl-2 and p53) which play a
critical role in the apoptotic mechanisms in patients with squamous cell
laryngeal carcinoma. MATERIALS AND METHODS: The immunohistochemical
expression of bcl-2, bax and p53 genes was retrospectively examined in
38 patients with squamous cell laryngeal carcinoma and in five controls
(necrotomic tissue). Tissue specimens were obtained both during the
diagnostic biopsy and at the time of surgery. Clinicopathological and
survival data were correlated with the staining results. RESULTS: Bcl-2
protein expression (P=0.0472), stage (P=0.0087) and lymph-node
involvement (P=0.0488) were found to be independent prognostic factors.
Increased bcl-2 protein expression correlated with a better 5-year
survival (P=0.0472). Patients who were bcl-2(-)/p53(-) (n=25) or
bax(+)/bcl-2(-) (n=13) had a significantly worse overall survival
(P=0.0305 and P=0.0482, respectively). Similarly, patients who were
bax(+)/bcl-2(-)/p53(-) (n=11) also had a worse 5-year survival compared
with the rest of the group (P=0.0088). Changes that were noticed in bax
and p53 protein expression from the time of biopsy until the time of
surgery did not correlate with a significant increase in the overall
survival. CONCLUSIONS: The expression of bcl-2 gene appears to be an
independent prognostic factor for patients with laryngeal carcinoma. The
coexpression of the genes studied can be used to determine aggressive
clinical phenotypes. Copyright 2001 Harcourt Publishers Limited.
12
UI - 11557449
AU - Myssiorek D; Halaas Y; Silver C
TI -
Laryngeal and sinonasal paragangliomas.
SO - Otolaryngol Clin North Am 2001 Oct;34(5):971-82, vii
AD - Department of Otolaryngology and Communicative Disorders, Long Island
Jewish Medical Center, Albert Einstein College of Medicine, New Hyde
Park, New York 11040, USA.
Laryngeal paragangliomas are classified as supraglottic and
infraglottic. This article defines each type of paraganglioma, discusses
the clinical features and diagnoses, and covers the surgical management.
This article also addresses sinonasal paragangliomas, including their
clinical features, diagnosis, and treatment.
13
UI - 11562393
AU - Zheng Z; Park JY; Guillemette C; Schantz SP; Lazarus P
TI -
Tobacco carcinogen-detoxifying enzyme UGT1A7 and its association with
orolaryngeal cancer risk.
SO - J Natl Cancer Inst 2001 Sep 19;93(18):1411-8
AD - Division of Cancer Control, H. Lee Moffitt Cancer Center and Research
Institute, Interdisciplinary Oncology Program and Department of
Biochemistry, University of South Florida, Tampa 33612, USA.
BACKGROUND: UDP-glucuronosyltransferase 1A7 (UGT1A7) detoxifies several
tobacco carcinogens. We determined whether UGT1A7 expression is observed
in normal orolaryngeal tissue and whether UGT1A7 allelic variations are
associated with the risk for orolaryngeal cancer. METHODS: UGT1A7
expression in normal orolaryngeal tissue was determined by
semiquantitative reverse transcription-polymerase chain reaction (PCR).
Buccal cell DNA isolated from 194 case subjects with orolaryngeal cancer
and from 388 control subjects who were matched by sex, age, and race was
subjected to UGT1A7 genotyping with the use of combined PCR-restriction
fragment length polymorphism and allelic discrimination analysis. All
statistical tests were two-sided. RESULTS: UGT1A7 messenger RNA was
expressed at similar levels in the esophagus, tongue, tonsil, floor of
the mouth, and larynx. Genotyping revealed the presence of three variant
reduced-activity UGT1A7 alleles in both Caucasians and
African-Americans. Individuals with any of the predicted low-activity
UGT1A7 genotypes had an increased risk of orolaryngeal cancer (odds
ratio [OR] = 3.7; 95% confidence interval [CI] = 1.7 to 8.7) relative to
subjects with the wild-type genotype. Both Caucasians and
African-Americans with the low-activity genotypes had statistically
significantly increased orolaryngeal cancer risk compared with
Caucasians and African-Americans with the wild-type genotype (OR = 2.8
[95% CI = 1.1 to 7.6] and OR = 6.2 [95% CI = 1.2 to 31], respectively).
For subjects with the predicted low-activity genotypes, the risks of
oral cavity cancer (OR = 4.2; 95% CI = 1.7 to 10) and laryngeal cancer
(OR = 3.7; 95% CI = 0.99 to 14) were similar. There was no association
between UGT1A7 genotype and orolaryngeal cancer risk in never smokers,
whereas subjects with predicted low-activity UGT1A7 genotypes who were
light smokers (OR = 3.7; 95% CI = 1.1 to 12) or heavy smokers (OR = 6.1;
95% CI = 1.5 to 25) had an increased risk. CONCLUSIONS: The tissue
expression of UGT1A7 is consistent with the possibility of a physiologic
role in orolaryngeal cancer. Variations in the UGT1A7 gene that reduce
UGT1A7 activity may affect the risk of smoking-related orolaryngeal
cancer.
14
UI - 11580231
AU - Vambutas A; DeVoti J; Pinn W; Steinberg BM; Bonagura VR
TI -
Interaction of human papillomavirus type 11 E7 protein with TAP-1
results in the reduction of ATP-dependent peptide transport.
SO - Clin Immunol 2001 Oct;101(1):94-9
AD - Department of Otolaryngology, The Long Island Campus for the Albert
Einstein College of Medicine, New Hyde Park, New York 11040, USA.
Human papillomaviruses (HPVs) cause benign and malignant epithelial
tumors of the respiratory and genital mucosa. We previously reported
that recurrent respiratory papillomas caused by HPV 6/11 express low
levels of antibody-detectable TAP-1, the protein that transports
peptides into the endoplasmic reticulum for assembly and presentation by
MHC Class I, and that the extent of TAP-1 immunostaining is inversely
related to the frequency of disease recurrence. We have now determined a
mechanism for the reduction in TAP-1 detection. Anti-TAP-1 antibody
immunoprecipitated very low amounts of protein from papilloma cells.
However, immunoprecipitation of calreticulin, another member of the MHC
I assembly complex, coprecipitated TAP-1 at levels comparable to those
of uninfected cells. Immunoprecipitation of an HPV-positive cell line
with either anti-TAP-1 or anti-calreticulin coprecipitated HPV E7
protein. Finally, purified HPV 11 E7 protein inhibited ATP-dependent
peptide transport in vitro. We propose that the interaction of E7 with
TAP-1 prevents TAP-1 antibody detection and efficient peptide transport,
resulting in poor presentation of viral antigen on HPV-infected cells
and thus failure to mount an effective immune-mediated prevention of
disease recurrence. Copyright 2001 Academic Press.
15
UI - 11601059
AU - Qi F; Zhang B; Xu Y
TI -
[Cisplatin-induced apoptosis in laryngeal squamous cell carcinoma strain
and the influence on cell cycle]
SO - Zhonghua Yi Xue Za Zhi 1999 Apr;79(4):298-301
AD - Department of Otolaryngology, Peking Union Medical College Hospital,
Beijing 100730.
OBJECTIVE: To find more effective chemotherapeutic agents and treatment
regimens, we studied the cytotoxicity of cisplatin to human laryngeal
squamous cell carcinoma strain Hep2. METHODS: Using flow cytometry,
fluorescence microscopy, and DNA agarose gel electrophoresis technique,
we investigated in vitro Hep2 cells in different conditions. RESULTS:
Hep2 was adherent cells in normal survival condition. Cisplatin affected
Hep2 cell growth apparently. Under fluorescence microscope, necrotic
cells were red, apoptotic cells were blue with condensed and fragmented
nuclei, and normal cells were evenly blue. Adherent cells were 86%-96%
viable. But nonadherent cells were 6%-13% viable. Death cells increased
with the increase of drug concentration and time elapsing. Death cells
were mainly apoptotic cells. The latter appeared to be time- and
dose-dependent. DNA "ladder" was observed for nonadherent cells in
agarose gel electrophoresis, but adherent cells were not. "Sub-G1" phase
peak occurred in flow cytometry. After cisplatin treatment, the volume
of adherent cells increased with dose- and time dependence. Cisplatin
could cause Hep2 cell cycle to change. At first, G1 phase cell
percentage reduced, while S phase increased. With time elapsing, G2/M
phase increased. Cells experienced a slow-down in S-phase followed by a
G2 block. CONCLUSION: Apoptosis is a major way of Hep2 cell death after
cisplatin treatment and appeared to be time- and dose-dependent. In
clinical chemotherapy, cisplatin should be used in high concentration.
Inducing apoptosis is one of the characteristics of chemotherapeutic
agents. Cisplatin should be taken a combination regimen with cell
cycle-special agents.
16
UI - 11605235
AU - Orlova NV; Smirnova SG; Zamulaeva IA; Andreev VG; Riabchenko NI; Saenko
TI -
AS
[Apoptosis of peripheral lymphocytes of healthy donors and patients with
laryngeal neoplasms after gamma-irradiation in vitro]
SO - Radiats Biol Radioecol 2001 Jul-Aug;41(4):366-72
AD - Medical Radiological Research Center, Russian Academy of Sciences,
Obninsk, 249020 Russia. mrrc@obninsk.ru
Apoptosis in peripheral blood lymphocytes of healthy donors and cancer
patients after gamma-irradiation with different doses was studied by the
flow cytometry method. Wide intra- and interindividual variabilities of
the lymphocyte radiosensitivity were observed. The radiosensitivity did
not depend on the subpopulation composition of the lymphocyte pool. The
persons with very low and high lymphocyte radiosensitivities were found
significantly more often among the cancer patients than among the
healthy donors. One can suggest that this method is useful as a
biomarker of future cancer risk and prognosis of radiotherapy
efficiency.
17
UI - 11600604
AU - Mendenhall WM; Amdur RJ; Morris CG; Hinerman RW
TI -
T1-T2N0 squamous cell carcinoma of the glottic larynx treated with
radiation therapy.
SO - J Clin Oncol 2001 Oct 15;19(20):4029-36
AD - Department of Radiation Oncology, University of Florida College of
Medicine, Gainesville, USA. mendewil@shands.ufl.edu
PURPOSE: The end results after radiation therapy for T1-T2N0 glottic
carcinoma vary considerably. We analyze patient-related and
treatment-related parameters that may influence the likelihood of cure.
PATIENTS AND METHODS: Five hundred nineteen patients were treated with
radiation therapy and had follow-up for >or= 2 years. Three patients who
were disease-free were lost to follow-up at 7 months, 21 months, and
10.5 years. No other patients were lost to follow-up. RESULTS: Local
control rates at 5 years after radiation therapy were as follows: T1A,
94%; T1B, 93%; T2A, 80%; and T2B, 72%. Multivariate analysis of local
control revealed that the following parameters significantly influenced
this end point: overall treatment time (P < .0001), T stage (P = .0003),
and histologic differentiation (P = .013). Patients with poorly
differentiated cancers fared less well than those with better
differentiated lesions. Rates of local control with laryngeal
preservation at 5 years were as follows: T1A and T1B, 95%; T2A, 82%; and
T2B, 76%. Cause-specific survival rates at 5 years were as follows: T1A
and T1B, 98%; T2A, 95%; and T2B, 90%. One patient with a T1N0 cancer and
three patients with T2N0 lesions experienced severe late radiation
complications. CONCLUSION: Radiation therapy cures a high percentage of
patients with T1-T2N0 glottic carcinomas and has a low rate of severe
complications. The major treatment-related parameter that influences the
likelihood of cure is overall treatment time.
18
UI - 11642434
AU - dos Santos CR; Goncalves Filho J; Magrin J; Johnson LF; Ferlito A;
TI -
Kowalski LP
Involvement of level I neck lymph nodes in advanced squamous carcinoma
of the larynx.
SO - Ann Otol Rhinol Laryngol 2001 Oct;110(10):982-4
AD - Department of Otorhinolaryngology-Head and Neck Surgery, Center for
Treatment and Research, A. C. Camargo Cancer Hospital, Sao Paulo,
Brazil.
This study was performed to evaluate the incidence of metastasis at
level I in patients with squamous laryngeal cancer. One hundred
consecutive patients with squamous carcinoma of the larynx were
submitted to surgical treatment including radical neck dissection. The
tumor stage was T3 or T4, and the neck stage was N1-N2c. Lymph node
metastases were pathologically confirmed in 80 patients. Metastases were
concentrated within level II in 59% of cases, level III in 17% of cases,
level IV in 11% of cases, and level V in 6% of cases. Only 2 patients
(2%) had detectable tumors in the lymph nodes of the submandibular
triangle (level IB). This study shows that patients with laryngeal
cancer rarely present metastases at the submandibular triangle, even in
advanced local disease with cervical metastasis staged as N1 to N2c.
Therefore, dissection of the submandibular triangle is indicated only in
the presence of clinical, radiographic, or cytologic evidence of
metastatic disease at level I.
19
UI - 11668514
AU - Ranelletti FO; Almadori G; Rocca B; Ferrandina G; Ciabattoni G; Habib A;
TI -
Galli J; Maggiano N; Gessi M; Lauriola L
Prognostic significance of cyclooxygenase-2 in laryngeal squamous cell
carcinoma.
SO - Int J Cancer 2001 Nov 20;95(6):343-9
AD - Institute of Histology, Universita Cattolica del S. Cuore, Roma, Italy.
ranelletti@em.unicatt.it
Epidermal growth factor receptor (EGFR) overexpression is an unfavorable
prognostic marker in laryngeal squamous cell carcinoma (SCC). EGFR
stimulates cyclooxygenase-2 (COX-2) expression in normal human
keratinocytes and squamous carcinoma cells. Based on these observations
a prognostic role of COX-2 expression in laryngeal SCC can be
hypothesized. Consequently, COX-2 expression was studied in laryngeal
SCC (median follow-up = 47 months; range: 2-87 months) by quantitative
immunohistochemistry (n = 61) and EGFR by binding assay (n = 51).
Well-differentiated regions of laryngeal SCC revealed strong COX-2
immunostaining, whereas histologically normal areas neighboring tumor as
well as poorly-differentiated tumors were negative. Immunohistochemical
results were confirmed by Western blot analyses. Cox's regression
analysis showed that the combination of low levels of COX-2 integrated
density and high levels of EGFR covariates provided strong prediction,
at 5-year follow-up, of both poor overall survival (chi(2) = 12.905; p =
0.0016) and relapse-free survival (chi(2) = 9.209; p = 0.01). In vitro
studies on CO-K3 cell line, obtained from an EGFR positive, COX-2
negative poorly-differentiated laryngeal SCC, revealed that EGF
stimulation failed to induce COX-2 expression and PGE2 production
suggesting a change in EGFR signaling pathway. These findings indicate
that COX-2 is overexpressed in less aggressive, low grade laryngeal SCC,
whereas its expression is lost when tumors progress to a more malignant
phenotype. Copyright 2001 Wiley-Liss, Inc.
20
UI - 11685560
AU - Machens A; Hinze R; Dralle H
TI -
Surgery on the cervicovisceral axis for invasive thyroid cancer.
SO - Langenbecks Arch Surg 2001 Aug;386(5):318-23
AD - Department of General Surgery, Martin Luther University,
Halle-Wittenberg, Ernst Grube Strasse 40, 06097 Halle/Saale, Germany.
gensurg@medizin.uni-halle.de
BACKGROUND AND AIMS: Invasion of the cervicovisceral axis (i.e., larynx
trachea esophagus) by thyroid cancers still poses a surgical challenge.
patients who underwent surgery at this institution for differentiated
(DTC) or medullary (MTC) thyroid carcinoma invading the cervicovisceral
axis were recruited into this study. RESULTS: The cervicovisceral axis
was invaded in 34 consecutive patients (19 DTC, 15 MTC). Of these, 20
patients underwent cervicovisceral resections. These resections were
performed less often in MTC than in DTC patients (20% versus 89%;
P<0.0001). Full-thickness invasion was present in 3 patients (2 DTC, 1
MTC). In the 20 resectional patients, tracheal wedge resection was the
most common procedure followed by extramucosal esophageal resection.
Surgical mortality was nil. There were five major complications, most of
which occurred in either lateral tracheal or high-risk combined
laryngo-tracheo-esophageal resections. CONCLUSION: The surgical approach
to invasive thyroid carcinoma must balance surgical morbidity against
the potential benefits of cervicovisceral resection. Individual factors
must be considered, such as patient age and co-morbidity, the extent and
nature of the tumor, and quality-of-life issues. Lateral resection of
the trachea may cause significant tracheal instability and morbidity
and, thus, be inferior to segmental tracheal resection.
21
UI - 11692950
AU - Lorente J; Rubio A; Quesada JL; Subirana FX; Simo M; Diez MJ; Perez M;
TI -
Garcia M; Quesada P; Castell J
[Usefulness of 201T1 gammagraphy in the diagnosis of carcinoma of the
larynx]
SO - Acta Otorrinolaringol Esp 2001 Oct;52(7):594-600
AD - Servicio de Otorrinolaringologia, Hospital General Universitario Vall
D'Hebron, Pg. Vall d'Hebron, no. 119-129, 08035 Barcelona.
For the evaluation of a patient with a laryngeal tumor we need the
clinical exam and other exams as the CT scan or MRI. Those studies have
a sensitivity of less than 80%. For that reason in the last years there
has been a development of new techniques trying to increase the
accuracy. The 201Tl SPECT is one of them although it was developed for
cardiological purposes. We present our experience in 46 patients with
laryngeal tumor in whom we did a 201Tl SPECT as part of the extension
study. The sensitivity of the study was 81.6% in the diagnosis of the
primary tumor and 46.1% for the neck adenopathies. The 201Tl SPECT can
be a good method for the evaluation and detection of recurrences in
patients with pharyngo-laryngeal tumor.
22
UI - 11700453
AU - Aygenc E; Selcuk A; Celikkanat S; Ozbek C; Ozdem C
TI -
The role of Helicobacter pylori infection in the cause of squamous cell
carcinoma of the larynx.
SO - Otolaryngol Head Neck Surg 2001 Nov;125(5):520-1
AD - Ankara Numune Hospital, 2nd Otorhinolaryngology-Head and Neck Surgery
Department, Izmir, Turkey. eaygenc@turk.net
OBJECTIVE: Helicobacter pylori can cause chronic infection that has been
linked to the development of both benign and malignant disease of the
aerodigestive tract. The purpose of this study was to determine the link
between H pylori infection and squamous cell carcinoma of the larynx
(SCCL). METHODS: We estimated the presence of IgG antibodies against H
pylori antigens by using ELISA technique in the sera of 26 patients with
SCCL and 32 matched controls without carcinoma of the larynx. RESULTS:
The incidence of seropositivity of patients with SCCL was 73.07% and of
controls was 40.62%. These data support an etiologic role for H pylori
infection on development of SCCL (chi(2) = 4.85, P< 0.05). CONCLUSION: H
pylori infection of the upper aerodigestive tract might result in
mucosal disruption, allowing for subsequent transformation by known
carcinogens such as tobacco and alcohol.
23
UI - 11710640
AU - Hagedorn H; Elbertzhagen A; Ruoss I; Sauer U; Nerlich AG
TI -
Immunohistochemical analysis of major TGF-beta isoforms and their
receptors in laryngeal carcinomas.
SO - Virchows Arch 2001 Oct;439(4):531-9
AD - Department of Otolaryngology, Head and Neck Surgery, University of
Munich, Grosshadern Medical Center, Germany.
We analyzed immunohistochemically the tissue distribution of the three
major transforming growth factors-beta isoforms (TGF-beta1, -2, -3) and
their receptors (TBR-I, -II and -III) in tissue samples from 38 patients
with laryngeal squamous cell carcinomas. Besides a qualitative
evaluation, the number of the respectively labeled cells was determined
by morphometric analysis. In all tumor samples a significant staining of
most tumor cells was seen both for the TGF-beta isoforms and the TBRs.
Similarly, the majority of stromal cells were labeled. On semiserial
sections, there were only minor differences in the distribution pattern
and in the number of labeled cells between the three TGF-beta isoforms
and the TBRs, suggesting that most tumor cells are actively involved in
the neosynthesis of TGF-betas and TBRs; accordingly, at least most tumor
cells seem to be capable of producing more than one TGF-beta form and in
parallel several TBRs. With decreasing tumor cell differentiation the
number of TGF-beta- and TBR-positive tumor cells decreased slightly (but
not to a statistically significant degree). Interestingly, the stromal
cells were labeled for TGF-betas and TBRs to a lower extent than the
epithelial cells, and there was no significant difference between
non-tumor-associated control stroma and the immediate peritumoral
stroma. Our observations suggest an even, enhanced level of TGF-beta
production in laryngeal squamous cell carcinomas, which may explain some
well-known side-effects of tumor growth, such as stromal desmoplasia. In
addition, the presence of immunoreactive TBR-proteins in the vast
majority of tumor cells excludes the mere absence of TBRs in those
carcinomas as the cause for inappropriate TGF-beta function in the tumor
cells. This in turn suggests that molecular alterations either of the
TBR-proteins non-affecting the synthesis and turnover or downstream
alterations of the TGF-beta signaling pathway may be main reasons for
the loss of response of the tumor cells to the enhanced amounts of
TGF-betas.
24
UI - 11717891
AU - Xu X; Zhao M; Shi Y
TI -
[Expression of heat shock proteins in laryngeal carcinoma]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Aug;33(4):232-4
AD - Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing 100021.
OBJECTIVE: To determine the expression of HSPs(HSP90 alpha, HSP90 beta,
HSP70, HSP27) in laryngeal carcinoma and normal laryngeal mucosa.
METHODS: Total RNA were extracted from 21 laryngeal cancer tissue
samples and the normal mucosa of the corresponding larynx. The
expression of HSPs mRNA was examined by Slot blot analysis. RESULTS: 1.
HSP90 alpha and HSP70 were selectively overexpressed 5 times more in
laryngeal carcinoma than in normal mucosa of larynx. 2. HSP90 beta and
HSP27 were constitutively expressed at low level in these two groups.
There was no significant difference between the levels of expression of
HSP90 beta and HSP27 in laryngeal carcinoma and normal controls.
CONCLUSION: The results that HSP90 alpha and HSP 70 mRNA were
selectively overexpressed in laryngeal carcinoma suggested that HSP90
alpha and HSP70 might play a specific role in the pathogenesis of
laryngeal cancer. To clarify the mechanism of HSPs action could help to
provide theorical basis for the biological therapy of laryngeal cancer.
25
UI - 11717894
AU - Li G; Xu Y; Zheng Y
TI -
[Evaluation of magnetic resonance imaging in staging of laryngeal
cancer]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Aug;33(4):240-1
AD - Memorial Hospital, Sun Yat-Sen University of Medical Sciences, Guangzhou
510120.
OBJECTIVE: To evaluate the value of the preoperative T staging of
laryngeal cancer by MRI. METHODS: The MRI data of 59 cases of laryngeal
cancer were retrospectively staged, and compared with the findings of
laryngoscopy and postsurgical pathologic staging. RESULTS: The accuracy
of staging in each T stage of laryngeal cancer was: T1:95% (20/21),
T2:88% (15/17), T3:85% (11/13) T4:100% (8/8) by MRI, vs T1:91% (19/21),
T2:88% (15/17), T3:47% (8/13), T4:13% (1/8) by laryngoscopy. The total
accuracy of MRI vs laryngoscopy was 92% (54/59) vs 73%(43/59). P < 0.01.
CONCLUSION: MRI can correctly depict the invasion of the preepiglottic
space (PES), paraglottic space (PGS) and cartilage by laryngeal cancer
and can greatly improve the accuracy of preoperative staging. It was
considered that MRI of great importance in determining appropriate
therapy for laryngeal cancer.
26
UI - 11717897
AU - Yany Z; Li Z; Jiang A
TI -
[Application of CT virtual endoscopy in larynx]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Aug;33(4):247-8
AD - Department of Radiology, First Affiliated Hospital, Sun Yat-sen
University of Medical Sciences, Guangzhou 510080.
OBJECTIVE: To evaluate the clinical application of CT virtual endoscopy
in larynx. METHODS: The virtual endoscopy images were compared with that
of actual laryngoscopy in 16 patients(4 normal larynx, 9 laryngeal
carcinomas, 1 bilateral glottic polyps, one laryngeal fibrous
hyperplasis and 1 airway striction caused by infiltration of the
laryngeal carcinoma after laryngectomy). All the lesions were
pathologically proved. RESULTS: CT virtual endoscopy showed the normal
anatomical structure of larynx as actual laryngoscopy. The location and
extension of the lesions of larynx showed in CT virtual endoscopy agreed
with that of actual laryngoscopy. In addition, CT virtual laryngoscopy
revealed the structure of subglottic region and distal portion of
strictured airway from feet to head, which were not available in actual
laryngoscopy. CONCLUSION: CT virtual laryngoscopy is a good complemental
method of fiber optic laryngoscopy.
27
UI - 11717865
AU - Quan C; Guo X
TI -
[Analysis of Myc gene family in laryngeal cancer]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Oct;33(5):273-5
AD - Department of Otolaryngology Head and Neck Surgery, First Teaching
Hospital, Norman Bethune University of Medical Sciences, Changchun
130021.
OBJECTIVE: To study the abnormal amplification and role of Myc gene
family in the development of laryngeal cancer. METHOD: A PCR-PAGE-Laser
scanning technique was applied. RESULTS: There was no Myc gene
amplification in the normal laryngeal tissues. The abnormal L-myc and
C-myc gene were positive in 47% (15/32) of laryngeal cancers and 41%
(13/32) of the cancers shown the N-myc gene amplification. Myc gene
amplification was not related to age, sex and differentiation (P >
0.05), but the N-myc amplification was higher in patients with lymph
node metastasis (P < 0.05). CONCLUSION: The N-myc amplification may play
a role of positive regulation in the lymph metastasis of laryngeal
cancer. The abnormal amplification of Myc gene family is one of the
causes in development of laryngeal cancer.
28
UI - 11717866
AU - Pan Z; Yan A; Guo X
TI -
[Laryngeal reconstruction after near-total laryngectomy]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Oct;33(5):276-8
AD - First Affiliated Hospital, China Medical University, Shenyang 110001.
OBJECTIVE: To reduce the rate of near-total laryngectomy and reconstruct
laryngeal function. METHOD: A retrospective review was made on 19
patients treated by near-total laryngectomy and laryngeal reconstruction
from 1991 to 1996. Eight patients were male and 11 were female. The age
range was from 40 to 74 years, with a mean age of 57.6. Two cases were
in stage II, 9 cases stage III, 8 cases stage IV. The characteristic of
this operation is to remove hyoid bone and reduce aspiration. RESULTS:
Speech function in all patients was good. Deglutition in most patients
was good. Five patients breathed through the larynx after decannulation.
Fourteen patients respired through tracheostoma because of stenosis of
laryngeal cavity. Among them, 10 cases did not need cannula for their
wide tracheostomas, 4 cases needed cannula. Three-year survival rate was
78.6%(11/14), 5-year survival rate was 75%(3/4). CONCLUSION: Laryngeal
reconstruction near-total laryngectomy is helpful to restore laryngeal
function and decrease the rate of total laryngectomy.
29
UI - 11713427
AU - Mahlstedt K; Netz U; Schadel D; Eberle HG; Gross M
TI -
An initial assessment of the optical properties of human laryngeal
tissue.
SO - ORL J Otorhinolaryngol Relat Spec 2001 Nov-Dec;63(6):372-8
AD - Department of Audiology and Phoniatrics, University Hospital Benjamin
Franklin, Freie Universitat Berlin, Fabeckstrasse 62, D-14195 Berlin,
Germany. mahl@zedat.fu-berlin.de
The optical properties of human laryngeal tissue have been examined over
the whole wavelength range from 400 to 2,200 nm to facilitate the
development of new laser applications. Tissue samples were taken from
healthy vocal fold and from vocal fold of patients with papillomatosis
and with chronic, nonspecific laryngitis. The transmission and
scattering properties of the tissue samples were recorded with a
computer-guided integrating-sphere system. From the measured data the
optical properties were calculated by means of the inverse Monte Carlo
simulation. In the 500- to 600-nm range papilloma tissues had a
considerably higher absorption than healthy vocal fold. When applying
the optical tissue properties as a possible influencing factor of the
effectiveness of laser systems, laser applications at this wavelength
range may be useful in the ablation of papilloma tissue. Copyright 2001
S. Karger AG, Basel
30
UI - 11733319
AU - Bely-Toueg N; Halimi P; Laccourreye O; Laskri F; Brasnu D; Frija G
TI -
Normal laryngeal CT findings after supracricoid partial laryngectomy.
SO - AJNR Am J Neuroradiol 2001 Nov-Dec;22(10):1872-80
AD - Departments of Radiology, Hospital Laennec, University of Paris, France.
BACKGROUND AND PURPOSE: Supracricoid horizontal partial laryngectomy
(SCPL) is increasingly used to treat endolaryngeal carcinoma. However,
few radiologic reports of these procedures exist. Our purpose was to
evaluate the normal CT appearance of the neolarynx after surgery.
METHODS: SCPL includes cricohyoidopexy (CHP), cricohyoidoepiglottopexy
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